Rasch Analysis of the Chinese Version of the Nociception Coma Scale–Revised in Patients with Prolonged Disorders of Consciousness.

This study focuses on evaluating the psychometric properties of the Chinese version of the Nociception Coma Scale–Revised (NCS-R) in patients with prolonged disorders of consciousness, specifically those diagnosed with Minimally Conscious State (MCS) or Unresponsive Wakefulness Syndrome (UWS). Using Rasch modeling on data from 84 patients and 252 observations, the scale demonstrated unidimensionality, strong item reliability, and good item fit, though person reliability and item-person targeting were suboptimal, partly due to the patients’ generally low responsiveness and the scale’s item difficulty distribution. Differential item functioning related to gender was identified in motor and verbal subscales but not for etiology or time since lesion, supporting the scale’s invariance across different causes of consciousness disorders. The findings suggest that the Chinese NCS-R is a valid and reliable tool for assessing nociceptive responses in non-communicative patients with prolonged disorders of consciousness, aiding clinicians in pain evaluation and management.